A 20-year-old female presented to our Emergency Department (ED) complaining of intermittent vaginal bleeding for approximately 4 weeks. She was referred to the ED after being seen at an outside clinic earlier the same day and found to have a positive pregnancy test. The patient was surprised to find out that she was pregnant, as she had an intrauterine contraceptive device (IUCD) placed after the birth of her last child 2 years earlier. The patient was Gravida 5, Para 3, and reported that her last menstrual period was 8 weeks prior to her ED visit. She had had three normal-term spontaneous vaginal deliveries, the last one of which was 2 years ago. She was in good health, was on no medications, and had no complaints other than vaginal bleeding.
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Accepted: October 17, 2000
Received in revised form: September 22, 2000
Received: March 3, 2000
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.